Can TV Improve Us?

We’ve heard it for years: television is bad for us. Maybe instead of fighting against it, we should be trying to make it better. Some public health groups have had surprising success in using television for positive ends.

It's eight o'clock Wednesday evening and a rumor is circulating at a small-town high school in Massachusetts that a student named Jack is gay. Jack's friends—one of whom is a 15-year-old girl who has been sexually active since she was 13, and another of whom has a mother who has recently committed adultery—assure him it would be okay with them if he were, but admit their relief when he says he isn't. An hour later, in San Francisco, a woman named Julia is being beaten by her boyfriend. Meanwhile, in Los Angeles, a young stripper who has given birth out of wedlock learns that her own mother locked her in a basement when she was three years old, an experience that she thinks may explain her inability to love her own child.

A typical evening in America? If a visitor from another planet had turned on the television (specifically the WB and Fox networks) on the evening of Wednesday, February 10, 1999 with the aim of learning about our society, he would likely have concluded that it is made up pretty exclusively of photogenic young people with disintegrating nuclear families and liberal attitudes about sex. It's obviously not an accurate picture, but what might our visitor have learned from the programs he watched? Would all the sex, violence, and pathology he saw teach him antisocial behavior? Or might he glean from prime-time dramas and sitcoms the behavior and attitudes that he would do well to adopt if he intended to go native in America?

This is not an idle question—not because aliens might be watching American television, but because people are, particularly impressionable children and teenagers. In a time when 98 percent of U.S. households own at least one television set—a set which is turned on for an average of nearly seven hours a day—the degree to which people learn from and emulate the behavior of the characters they see on TV is an academic cottage industry. Some evidence does support the widespread belief that children and teenagers are affected by violence and other antisocial behavior in the media. When Dan Quayle made his infamous comments in 1992 about Murphy Brown having a baby out of wedlock, he was merely doing what numerous concerned parents, ethnic groups, religious organizations, gun-control advocates, and others were already doing—blaming television for encouraging certain types of behavior.

But if television contributes to poor behavior, might it also be a vehicle for encouraging good behavior? In 1988, Jay Winsten, a professor at the Harvard School of Public Health and the director of the school's Center for Health Communication, conceived a plan to use television to introduce a new social concept—the "designated driver"—to North America. Shows were already dealing with the topic of drinking, Winsten reasoned, so why not add a line of dialogue here and there about not driving drunk? With the assistance of then–NBC chairman Grant Tinker, Winsten met with more than 250 writers, producers, and executives over six months, trying to sell them on his designated driver idea.

Winsten's idea worked; the "designated driver" is now common parlance across all segments of American society and in 1991 won entry into a Webster's dictionary for the first time. An evaluation of the campaign in 1994 revealed that the designated driver "message" had aired on 160 prime-time shows in four seasons and had been the main topic of twenty-five 30-minute or 60-minute episodes. More important, these airings appear to have generated tangible results. In 1989, the year after the "designated driver" was invented, a Gallup poll found that 67 percent of adults had noted its appearance on network television. What's more, the campaign seems to have influenced adult behavior: polls conducted by the Roper Organization in 1989 and 1991 found significantly increasing awareness and use of designated drivers. By 1991, 37 percent of all U.S. adults claimed to have refrained from drinking at least once in order to serve as a designated driver, up from 29 percent in 1989. In 1991, 52 percent of adults younger than 30 had served as designated drivers, suggesting that the campaign was having greatest success with its target audience.

In 1988 there were 23,626 drunk driving fatalities. By 1997 the number was 16,189. While the Harvard Alcohol Project acknowledges that some of this decline is due to new laws, stricter anti–drunk driving enforcement, and other factors, it claims that many of the 50,000 lives saved by the end of 1998 were saved because of the designated driver campaign. (The television campaign was only a part of the overall campaign; there were strong community-level and public service components as well.) As evidence, the project cites statistics showing the rapid decline in traffic fatalities per 100 million vehicle miles traveled in the years during and immediately following the most intensive period of the designated driver campaign. Officials at the National Highway Traffic and Safety Administration have stated that the only way to explain the size of the decline in drinking-related traffic fatalities is the designated driver campaign.

Following the success of the Harvard Alcohol Project's campaign, various other advocacy groups—the majority of them with progressive leanings—have begun to work within the existing structures of the television industry in a similar fashion, attempting to influence programming in a positive direction. In truth, there are limits to the effect any public interest group can have on what gets broadcast. Commercial television's ultimate concerns are Nielsen ratings and advertisers. Thus there will always be a hefty quantity of sex and violence on network television. As Alfred Schneider, the former vice president of policy and standards for ABC, asserts in his contribution to the forthcoming anthology Advocacy Groups and the Television Industry, "While [television] can raise the consciousness of the nation, it should not be considered as the major vehicle for social relief or altering behavior."

But why not?

Maude's Abortion

Throughout the first decades of television, advocacy groups generally tried to work against television rather than with it. Their strategies for changing "offensive" television content consisted of boycotts, letter-writing campaigns, and protests to the networks' Standards and Practices departments. When issue-oriented comedies and dramas began to proliferate during the 1960s and 1970s, groups dedicated specifically to lobbying television began to form. In 1973, for example, pressure from Jewish groups led Bridget Loves Bernie, a CBS show that portrayed an interfaith marriage, to be canceled after a single season. That same year a group called the Gay Activist Alliance staged a sit-in at ABC to complain about portrayals of gay characters on Marcus Welby, M.D. In some instances, protesters came from both sides of the political spectrum. A recurring gay character portrayed by Billy Crystal on ABC's Soap beginning in the late 1970s was the object of protests by both gay advocacy groups and the religious right, a situation reprised recently by Ellen on the same network.

But traditional protest tactics have rarely met with more than modest success and have had little, if any, long-term impact on what we see on television. (There are some key exceptions: lobbying by Action for Children's Television, for example, a grassroots organization founded in 1968, was integral to the passage of the Children's Television Act of 1990, which paved the way for more educational television.) Robert Pekurny, a former writer for Happy Days who is now a professor of communication at Florida State University, has done research showing that boycotts and protests of television have had little effect. He points out that the current boycott of Disney by Southern Baptists has had negligible impact, and he cites an instance where a boycott of the Fox network's Married With Children actually led to an increase in the show's ratings.

Working with television, instead of protesting against it, has been more effective. After attending meetings of the Washington-based Population Institute in 1971 and 1972, the producer Norman Lear was inspired to address population issues. Drawing on technical suggestions provided by the Los Angeles branch of Planned Parenthood, Lear put together a two-part storyline for CBS's Maude, in which the 47-year old title character gets an abortion. These controversial episodes, which aired in November 1972, were simultaneously hailed as groundbreaking by feminist groups and angrily boycotted by a number of Catholic groups.

In a foreshadowing of the Murphy Brown controversy, Maude became a political lightning rod. Anti-abortion groups cited the Federal Communications Commission's Fairness Doctrine and demanded equal time, on Maude or elsewhere in prime time, for the airing of anti-abortion opinions. Their demands were not met, and just weeks later, in January 1973, Roe v. Wade legalized abortion in all states. Eight months later when CBS re-ran the abortion episodes, the rancor had not subsided. A half-hour comedy had become a battleground over America's values. And whether or not Maude's decision to have an abortion actually altered anyone's views on the issue, the controversy suggests people had come to see television as playing a significant role in the shaping of our social morality.

After Maude, advocacy groups saw only sporadic results in Hollywood until 1988, when Jay Winsten launched his designated driver campaign, an unqualified success that remains the model for advocacy and public health groups seeking to inject their ideas and values into the public consciousness. Winsten estimates that there are now at least 150 groups vying for Hollywood's attention in some form or another. Because there are so many groups competing for influence, it's hard to imagine any one concept having the influence the designated driver did. For example, the Environmental Media Association, founded in 1989 to mobilize Hollywood around environmental issues, has not met with the same success, despite backing from industry leaders like Lear and Tom Cruise. It's easy to build a show around drunk driving; it's harder to build a compelling half-hour drama around a hole in the ozone layer, or the importance of recycling.

Felicity's Virginity

But other groups remain optimistic, emulating Winsten's method of treating television as a potential ally rather than an adversary and approaching writers and producers likely to be receptive to particular ideas. When writers and producers for the WB network's critically acclaimed new drama Felicity were working on the script for a two-part story about date rape, they wanted to make sure they got the details right. They sought the advice of experts from the Kaiser Family Foundation, a nonprofit that focuses on education about health issues; its Program on Entertainment Media and Public Health offers briefings, research services, and a hotline for script writers with health-related questions. "We were really aware of the message we were sending out," the show's executive producer Ed Redlich told me recently. "Given that our audience is teenage girls, we wanted to be correct. At the same time we didn't want it to be an extended public service announcement." As the scripts went through revisions, the show's writers sat down to discuss date rape with representatives from Kaiser, who had previously offered their services to the WB. In whom might a young woman confide after being raped? What kind of advice might a rape counselor provide? What physical tests would the woman undergo? What kind of message would the show be sending if the rapist didn't use a condom?

Meanwhile, WB network executive Susanne Daniels sought input on the Felicity scripts from Marisa Nightingale at the National Campaign to Prevent Teen Pregnancy, an advocacy group formed in 1995 with the goal of reducing teen pregnancies by one-third by the year 2005. Nightingale, the manager of media programs, spends her days meeting with writers and producers to offer statistics, information on birth control methods, and suggestions for how to incorporate pregnancy prevention into storylines. "I can't knock on every door in the country and discuss safe sex with teenagers," she says, "but if Bailey and Sarah on [the Fox network's] Party of Five discuss it, that's the next best thing."

According to a recent Kaiser Foundation survey, 23 percent of teens say they learn about pregnancy and birth control from television and movies. Clearly, we should be mindful of what exactly teenagers are watching. On a recent episode of Dawson's Creek two 16-year olds contemplating sex ran into each other at a drugstore only to discover they were standing in front of a condom display, which led to a frank discussion about safe sex. An episode of Felicity featured the title character researching birth control methods and learning the proper way of putting on a condom. Once prepared, Felicity then decided in the heat of the moment she wasn't quite ready to have sex. A young woman's decision to put off having sex is rarely portrayed in prime time, but Felicity is a strong character and her reasoning is probably convincing to a teenage audience. She may well have more influence on teenage girls than a public service announcement. (Since then, in the April 21 episode, Felicity did lose her virginity. The situation was handled tastefully; nothing graphic was depicted, but the audience was given to know that it was safe sex.)

While it is health groups who have had the most success positioning themselves as resources for Hollywood, because the issues they focus on recur most often on ER-era television, other groups have also had some luck using the same approach. For example, the Gay and Lesbian Alliance Against Defamation (GLAAD), which began as a protest organization, has evolved into a group whose strategy is to be a resource for the entertainment industry. As the group has established a presence in Hollywood, it has begun to incorporate itself into the development and pre-production planning of a variety of television shows.

Socially Engineered by an Angel

Of course, making television an explicit vehicle for manipulating behavior has its dangers. My idea of the good may not be yours; if my ideas have access to the airwaves but yours don't, what I'm doing will seem to you like unwanted social engineering. We can all agree that minimizing drunk driving is a good thing—but not everyone agrees on the messages we want to be sending to, say, teenage girls about abstinence versus condoms, about having an abortion, or about whether interfaith marriages are okay. Tele vision's power to mold viewers' understanding of the world is strong enough that we need to be aware that embedding messages about moral values or social behavior can have potent effects—for good or for ill.

For the moment, Hollywood's liberal tilt (yes, it really has one) makes it likely that the messages and values it chooses to incorporate into its television programs will be agreeable to progressives. But how active a role do we want television to play in the socialization of our youth? If advocacy groups can gain access to Hollywood with messages that seem like positive additions to existing fare, then they may someday be able to do the opposite—to instill, say, values of a particular religion or an intolerant political group through television.

Consider the popularity of CBS's Touched by an Angel, which has just completed its fifth season and has secured a regular place among the top ten Nielsen-rated programs. The show, which features angels—not winged creatures, but messengers of God who arrive to help mortals in times of crisis—has sparked a mini-trend in prime time. Along with its spin-off Promised Land and the WB's 7th Heaven, Touched by an Angel has carved out a new niche in family hour entertainment: fare that's endorsed by many groups on the religious right (as well as, to be fair, by people not of the Christian right who are seeking wholesome television entertainment).

7th Heaven's producer Brenda Hampton, who created the show for Aaron Spelling's production company (the creative force behind such racier fare as Beverly Hills 90210 and Melrose Place), emphasizes in interviews that she is not influenced by religious groups and that her goal is simply to create entertaining television. But Martha Williamson, the producer of Touched by an Angel, is very outspoken about her Christianity. While Williamson, too, emphasizes that she aims primarily to entertain, the program's religious message is unmistakably in the foreground. Williamson says she is regularly contacted by viewers who say the show helped them make a decision—to get in touch with a long-estranged relative or to stop smoking.

On its face there's nothing objectionable about this; in fact, it's probably good. And there's no evidence that Touched by an Angel is actively converting people, or making unwilling Jews or atheists into Christians. Still, the show does proselytize for a set of values that some viewers might find alienating or offensive. A more extreme version could become Big Brotherish propaganda, beamed into the homes and receptive minds of the seven-hour-a-day TV watchers. At this point, the most offensive thing about Touched by an Angel is its saccharine writing (even some religious groups have criticized it on these grounds). But it is perhaps telling that a Republican Congress has awarded Williamson a "Freedom Works Award" for "individuals and groups who seek the personal reward of accepting and promoting responsibility without reliance on or funding from the federal government."

What I Learned on ER

Given that writers have to create 22 episodes each season, it's not surprising that they are receptive to outside groups pitching socially redeeming story ideas. Dawson's Creek producer Paul Stupin estimates he sits down with three to five advocacy groups at the beginning of each season and always finds the meetings useful. The fact that large numbers of writers and producers attend briefings sponsored by Kaiser, the National Campaign to Prevent Teen Pregnancy, or Population Communications Inter national (which recently sponsored a "Soap Summit") suggests that others feel the same way.

The strongest evidence that advocates can effect change through partnerships with the television industry comes from the success of the designated driver campaign. While there are as of yet no large-scale studies exploring the effects of public health advocacy through television, a survey conducted by the Kaiser Foundation is enlightening. On April 10, 1997, NBC aired an episode of ER focusing on morning-after contraception, put together with the help of Kaiser Found ation research. Before the show aired, independent researchers interviewed 400 of the show's regular viewers about their knowledge of options for preventing unwanted pregnancy even after unprotected sex. In the week after the show aired, 305 more viewers were interviewed. The number of ER viewers who said they knew about morning-after contraception went up by 17 percent after the episode aired. The study concluded that up to six million of the episode's 34 million viewers learned about emergency contraception for the first time from the show (and 53 percent of ER viewers say they learn important health care information from the show).

Even the limited evidence provided by the ER study suggests the scope of television's power to educate and influence. And additional Kaiser studies suggest that the lobbying of public health groups advocating safe sex and birth control is not yet having nearly enough of a beneficial effect. While 25 percent of teenagers say they have learned "a lot" about pregnancy and birth control from TV shows and movies, and 40 percent say they have gotten ideas about how to talk to their boyfriend or girlfriend about sex from TV and movies, 76 percent say that one reason teens feel comfortable having sex at young ages is that TV shows and movies "make it seem normal" to do so.

Another problem: According to Kaiser, while 67 percent of ER viewers knew about morning-after contraception when questioned immediately following the show, only 50 percent knew about it when questioned two-and-a-half months later. This suggests that the 17 percent who gained new information about contraception from the episode may not have retained it. Jay Winsten says that because new information fades without repetition, for a single message to take hold the way the designated driver campaign did will require a barrage of appearances on a wide range of TV shows, over an extended period of time.

The role of advocacy groups as a resource for Hollywood writers and producers is growing, and it's worth taking seriously. Their approach—presenting ideas to a creative community that is constantly in need of ideas—is proving effective. Yes, the messages are diluted to fit sitcom or drama formats. Yes, for every "good value" that makes its way onto the small screen, a flurry of gunshots on another network will partly counteract it. And yes, when Time cites Ally McBeal as a factor in the demise of feminism, it is placing absurdly disproportionate responsibility on a television character, and on the creative community that invented her. Yet if the college women on Felicity practice safe sex, or if a prime-time parent talks about drugs—or adoption, or eating disorders, or the Holocaust—with a child, the message is likely to resonate with an audience comprised of people who relate to their favorite television characters as if they knew them.

Is television the ideal forum for a culture to define its values? No. As long as television remains a profit-driven industry, the best we can hope to do—especially those of us who have views in common with those who create television content (and fortunately for liberals, we tend to)—is to work within the existing system to make it better. We do need to be realistic about the limits of television in packaging messages to fit this format. To turn Friends into a show about capital punishment would be ineffective as well as dramatically unconvincing; but to encourage the producers of Dawson's Creek to portray young people facing the realistic consequences of adult decisions just might work.